Personal Growth, Student Life, Students, Uncategorized, Wellbeing

How to recognise and prevent burnout as a medical student

What is burnout?

Burnout – A state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.

HelpGuide

It’s no secret that medical school is tough and burnout is more common than it should be. It’s practically famous for students spending endless hours studying, countless tears and just feeling constantly stressed. After a recent conversation with some fourth-year medic friends of mine (I’m a first year medic) it honestly scared me and made me think, am I ready for this? Of course that thought only lasted a few minutes and I quickly returned to whatever work I was doing, but it begs the question, do any of us truly know what we’re signing ourselves up for when we decide to study medicine.

The scary thing is, after you graduate, it’s not exactly guaranteed to get better, in fact, it probably gets a bit worse. I’m not trying to be demotivating about medicine, because I myself am not demotivated, and am as enthused as ever to study medicine and become a doctor. It’s just something that we all need to think about.

We talk about it a lot on my course, in fact we have a whole module almost completely devoted to reflecting and learning how to look after ourselves and to balance being a medical student (and eventually a doctor) with just looking after yourself. It may seem silly to talk about feelings and how to reflect at this stage, but these are habits that you should start putting into practice as early as possible, because they will be vital in your future career.

Burnout is not the same thing as being stressed

Ultimately, high levels of stress for prolonged periods of time can lead to burnout, but they’re not the same thing. Stress is a normal part of studying, all students will get stressed sometimes. Sometimes a little bit of stress may give you that push to finish your work, but nobody should burn out.

People who are stressed can still be positive and optimistic, and know that once they have got the work done, they’ll feel better. But people experiencing burnout don’t have any motivation and are mentally exhausted.

Why do we experience burnout?

As I said before, prolonged periods of high levels of stress can lead to burnout, but it’s also not just as simple as that. According to the Well-being Index, there are a few different factors that contribute to medical student burnout:

Time

Studying medicine has the potential to take over your life if you don’t control it. This is something I learnt very quickly. There will always be more work to do, always more things to learn. But you have to learn when to stop and say enough is enough.

Finances

As with most students, medical students are not known for having lots of money to throw around. Money for textbooks and living expenses are bad enough, but then consider travel to and from placement, placement clothes etc.

‘Doctors don’t get sick’

There’s some weird belief that doctors don’t get sick, or that they don’t suffer from mental health problems. But the truth is, we’re all still just humans, and we all have our own struggles. There can be this pressure to ignore or downplay symptoms of mental health issues so we’re not seen as ‘weak’.

A complicated curriculum

Whilst no degree has a specific set curriculum, a medical degree is wider than most. You’ll never be able to learn everything about every disease and condition, and often you don’t know where you should be focusing your time and effort on.

Competition

Even after you get into medical school, it can still be quite competitive. My school tries not to encourage this competitiveness too much. However, at the end of the day, we’re all going to be ranked against each other, and this will matter when we’re applying for jobs.

Why do we need to learn to recognise burnout?

Medical student mental health is an important topic and one which the BMA cares about. Especially because mental health issues that develop whilst at medical school can still be present after qualifying and into training. 

According to a 2019 study, 82% of medical student participants could be classified as ‘disengaged’ and 85% could be classified as ‘exhausted’. This study also looked at substance abuse amongst medical students and found that 32% of students reported using drugs (29% had used cannabis) and 18% of them would classify as positive for CAGE alcohol misuse and dependency.

Whilst this study had quite a small sample size, it would be important to reproduce this on a larger scale.

These numbers are scary and if they’re accurate, something needs to be done to protect the mental health of students. Burnout has serious implications, not just to productivity and studying but on other mental health conditions.

How do I recognise burnout?

Learn to recognise the signs and symptoms of burnout:

Physical

  • Tiredness
  • Getting ill a lot
  • Headaches/muscle pain
  • Disrupted sleeping
  • Change in appetite

Emotional

  • Self-doubt
  • Feelings of helplessness and defeat
  • Feeling lonely and detached from the world
  • Lack of motivation
  • Increasingly pessimistic view of the world
  • Reduced satisfaction in daily life and from accomplishments

Behavioural

  • Ignoring responsibilities
  • Isolating yourself
  • Procrastinating important tasks
  • Turning to drugs or food to cope
  • Taking your frustrations out on other people

How do I deal with burnout?

So you’ve learnt about what burnout is, why it’s an important issue to address, and how to spot the signs of burnout, hopefully in yourself as well as in others. Now I’m going to tell you how to manage, and hopefully prevent, burnout.

According to HelpGuide, there are three R’s to help:

  • Recognise – recognise the symptoms of burnout
  • Reverse – seek support early and manage stress levels
  • Resilience – learn to manage stress better, by taking better care of yourself

Aside from this, there are other things that you can do as well

Have a good support network

Nobody can manage life ups and downs alone, which is why it’s important to have people who are there for you no matter what. This can be a mix of friends, family and other medical students. It’s good to speak to other medical students as they know exactly what you’re going through, but it’s also good to speak to friends and family who don’t study medicine, as sometimes it’s nice to detach yourself from medicine for a while.

Notice I said good support network and not just have a support network, this is because it really matters who is in it. It is important not to have negative people in your life who just drain you. I’m not talking about abandoning your friends when they are vulnerable because everyone will be negative at points as they go through their lows. I’m talking about people who are negative constantly, that make you feel bad about yourself or generally just require a lot of energy, these people need to go.

Find your ‘why’

That might sound really cheesy but it’s definitely something to think about. Chances are you will have thought about why you want to be a doctor when preparing for medical school interviews, but now it’s time to think about that again.

Think about why you wanted to be a doctor in the first place. Being a doctor is your goal, so tell me WHY that’s your goal. Knowing why you want to be a doctor and reminding yourself of that is key to having intrinsic motivation, which a great way of preventing burnout

Intrinsic motivation – being motivated to do something for your own personal reward, not to be rewarded by someone or something else, i.e. doing something for yourself.

This is why it’s really important to recognise why you want to study medicine before you even apply, because if you’re doing it to make somebody else happy, you’ll lack this intrinsic motivation, and you’re more likely to lead to burnout.

Set boundaries for yourself

As I said earlier, there will never be a point in your studies where you can sit back and think ‘I’ve finished all my work’, that finish line doesn’t exist in medicine, so you have to set it for yourself.

This could be a time-based target or a task-based target. So either you say to yourself, I’m only going to work on university work 9 to 5, or you say, I’m going to work until I’ve revised these five lectures and then I’m going to stop.

Schedule time for you

I’ve talked about this a lot in my post on mental health, and the same things apply here. Schedule time for yourself the way you would schedule to have dinner with a friend. Block that time out for you and don’t let yourself get dragged into anything else. If you want to spend that time socialising then go ahead, but I also think it’s important to spend time alone sometimes and do something you enjoy. You could watch a movie or do something artistic or whatever you enjoy, something that makes YOU happy and relaxed.

Visualise your goals

This is kind of related to ‘finding your why’ but on a smaller scale. Have smaller more measurable goals, check out my post on goal setting, visualise them, and smash them. Everybody needs little rewards, and that boost that you feel after completing a goal, is itself a little reward. 

Not only is this really good for keeping you on track, it’s also a good way to keep the end in focus. Sometimes you can only go through the hard times if you know it’s not forever. It’s like in exam season when you push yourself that little bit extra, you put in more hours, you cut back on the relaxation, and focus more on studying. The only reason you can do that is because you know this is only going to be for a certain period of time and you’re not going to be doing this forever. So keep the end goal in focus, and work towards it.

What if I already have burnout?

Don’t ignore the symptoms – burnout is not something that will go away if you ignore it, in fact it will just get worse

Ask for help – Reach out to your supervisors, tutors, heads of year or even a counselor. 

Make changes to your life and don’t expect overnight results – you didn’t reach burnout in a couple of days and you won’t recover completely in a couple of days. Make the changes to reduce your stress and improve your wellbeing and then implement them consistently.

Conclusions

  • Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress
  • You need to learn how to prevent burnout now, in order to set up good habits for later on in your career
  • Being stressed and having burnout is not the same thing, stress is kinda normal, burnout is definitely not
  • There are many factors to why medical student burnout including: lack of time, finances, falsely believing that ‘doctors don’t get sick’, not knowing when to stop studying and intense competition
  • Burnout is an important issue that needs more research, it is a serious mental health condition that can lead to other behaviours such as substance misuse
  • There are physical, emotional and behavioural symptoms and signs of burnout
  • Tackle burnout using the three R’s Recognise, Reverse, Resilience
  • Other tips for avoiding burnout
    • Have a good support network
    • Find your why
    • Set boundaries for yourself
    • Schedule time for you
    • Visualise your goals
  • If you already have burnout: don’t ignore the symptoms, seek help from others, make lifestyle changes and be consistent and patient!

Want to become a more productive student? Want to work on your personal development? Want to learn about how to get into medical school?

If you said YES to any of the above, then stick around because you’re in the right place!

Whether you’re a current or aspiring student, I share tips and tricks that are going to help you out.

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